Observation of Oscillatory Radial Electric Field Relaxation in a Helical Plasma.

Measurements of the relaxation of a zonal electrostatic potential perturbation in a nonaxisymmetric magnetically confined plasma are presented. A sudden perturbation of the plasma equilibrium is induced by the injection of a cryogenic hydrogen pellet in the TJ-II stellarator, which is observed to be followed by a damped oscillation in the electrostatic potential. The waveform of the relaxation is consistent with theoretical calculations of zonal potential relaxation in a nonaxisymmetric magnetic geometry. The turbulent transport properties of a magnetic confinement configuration are expected to depend on the features of the collisionless damping of zonal flows, of which the present Letter is the first direct observation.

Overview of diagnostic performance and results for the first operation phase in Wendelstein 7-X (invited).

Wendelstein 7-X, a superconducting optimized stellarator built in Greifswald/Germany, started its first plasmas with the last closed flux surface (LCFS) defined by 5 uncooled graphite limiters in December 2015. At the end of the 10 weeks long experimental campaign (OP1.1) more than 20 independent diagnostic systems were in operation, allowing detailed studies of many interesting plasma phenomena. For example, fast neutral gas manometers supported by video cameras (including one fast-frame camera with frame rates of tens of kHz) as well as visible cameras with different interference filters, with field of views covering all ten half-modules of the stellarator, discovered a MARFE-like radiation zone on the inboard side of machine module 4. This structure is presumably triggered by an inadvertent plasma-wall interaction in module 4 resulting in a high impurity influx that terminates some discharges by radiation cooling. The main plasma parameters achieved in OP1.1 exceeded predicted values in discharges of a length reaching 6 s. Although OP1.1 is characterized by short pulses, many of the diagnostics are already designed for quasi-steady state operation of 30 min discharges heated at 10 MW of ECRH. An overview of diagnostic performance for OP1.1 is given, including some highlights from the physics campaigns.

Status of the diagnostics development for the first operation phase of the stellarator Wendelstein 7-X.

An overview of the diagnostics which are essential for the first operational phase of Wendelstein 7-X and the set of diagnostics expected to be ready for operation at this time are presented. The ongoing investigations of how to cope with high levels of stray Electron Cyclotron Resonance Heating (ECRH) radiation in the ultraviolet (UV)/visible/infrared (IR) optical diagnostics are described.

[Duodenal tube test and hepatic ultrasound in extrahepatic biliary atresia diagnosis: A four-case series]. / Prueba de sonda duodenal y ultrasonido de hígado y vías biliares en el diagnóstico de atresia de las vías biliares extrahepáticas. Serie de 4 casos.

Liver and biliary tree scintigraphy and magnetic resonance cholangiography (MRC) have taken the place of the duodenal tube test (DTT) in the study of cholestatic jaundice due to extrahepatic biliary atresia (EBA). The usefulness of DTT associated with abdominal ultrasound (AUS) in the diagnosis of EBA was demonstrated in 4 patients presenting with cholestatic jaundice that underwent DTT and AUS; one of them also had MRC. DTT was negative for bile in the 4 patients; AUS did not identify the gallbladder or showed it as small and irregular, or detected a fibrous cord; MRC identified a choledochal cyst but no associated EBA; surgery and pathology study documented EBA in all 4 patients. DTT associated with AUS demonstrated the absence of bile in the duodenum and gallbladder abnormality, respectively, leading to surgical exploration within 24 to 48 hours.

Density fluctuation measurements using beam emission spectroscopy on Heliotron J.

This paper describes the measurement of the density fluctuation using beam emission spectroscopy in Heliotron J, having the non-symmetrical helical-magnetic-axis configuration. In order to optimize the sightlines, the numerical calculations are carried out to estimate the spatial resolution and the observation location. When a tangential neutral beam is used as diagnostic one, suitable sightlines from the newly installed diagnostic port are selected whose spatial resolution Δρ is less than ± 0.07 over the entire plasma region. Modification of the interference filter and the detection systems enables us to measure the radial profile of the density fluctuation. Each of the three coherent modes due to the fast-ion-driven magnetohydrodynamic instabilities has different radial structure of the density fluctuation.

A scalable and accurate method for classifying protein-ligand binding geometries using a MapReduce approach.

We present a scalable and accurate method for classifying protein-ligand binding geometries in molecular docking. Our method is a three-step process: the first step encodes the geometry of a three-dimensional (3D) ligand conformation into a single 3D point in the space; the second step builds an octree by assigning an octant identifier to every single point in the space under consideration; and the third step performs an octree-based clustering on the reduced conformation space and identifies the most dense octant. We adapt our method for MapReduce and implement it in Hadoop. The load-balancing, fault-tolerance, and scalability in MapReduce allow screening of very large conformation spaces not approachable with traditional clustering methods. We analyze results for docking trials for 23 protein-ligand complexes for HIV protease, 21 protein-ligand complexes for Trypsin, and 12 protein-ligand complexes for P38alpha kinase. We also analyze cross docking trials for 24 ligands, each docking into 24 protein conformations of the HIV protease, and receptor ensemble docking trials for 24 ligands, each docking in a pool of HIV protease receptors. Our method demonstrates significant improvement over energy-only scoring for the accurate identification of native ligand geometries in all these docking assessments. The advantages of our clustering approach make it attractive for complex applications in real-world drug design efforts. We demonstrate that our method is particularly useful for clustering docking results using a minimal ensemble of representative protein conformational states (receptor ensemble docking), which is now a common strategy to address protein flexibility in molecular docking.

Integrated data analysis at TJ-II: the density profile.

An integrated data analysis system based on Bayesian inference has been developed for the TJ-II stellarator. It reconstructs the electron density profile at a single time point, using data from interferometry, reflectometry, Thomson scattering, and the Helium beam, while providing a detailed error analysis. In this work, we present a novel analysis of the ambiguity inherent in profile reconstruction from reflectometry and show how the integrated data analysis approach elegantly resolves it. Several examples of the application of the technique are provided, in both low-density discharges with and without electrode biasing, and in high-density discharges with an (L-H) confinement transition.

Spatiotemporal structure of the interaction between turbulence and flows at the L-H transition in a toroidal plasma.

The spatiotemporal behavior of the interaction between turbulence and flows has been studied close to the L-H transition threshold conditions in the edge region (ρ≥0.7) of TJ-II plasmas. The temporal dynamics of the interaction displays an oscillatory behavior with a characteristic predator-prey relationship. The spatial evolution of this turbulence-flow oscillation pattern has been measured, showing both radial outward and inward propagation velocities of the turbulence-flow front. The results indicate that the edge shear flow linked to the L-H transition can behave either as a slowing-down, damping mechanism of outward propagating turbulent-flow oscillating structures, or as a source of inward propagating turbulence-flow events.

El espíritu de servicio y los valores éticos de enfermería / Spirit of service and ethical values in nursing

El estudio tuvo como Objetivo: la identificación de los valores éticos y de espíritu de servicio que aplica el personal de enfermería en un servicio clínico. Metodología: Se hizo un estudio descriptivo observacional y transversal, en una institución de segundo nivel de atención con 340 enfermeras adscritas, de las que 100 contestaron un formulario autoaplicable (emedic-1 con un alpha de Crombach de 0.915) de 26 ítems; entregado al inicio del turno y recogido, a través de las jefes de piso, al término de la jornada. La información se reporta en frecuencias relativas decrecientes. Las hipótesis direccionales plantean que: a) El nivel de espíritu de servicio en la muestra estudiada calificará como alto (siempre o en más del 80% de los casos) medio (casi siempre o entre el 60 y 79% de los casos ) o bajo (raras veces o menos del 59% de los casos) según la escala emedic-1; b) los valores éticos inherentes al cuidado enfermero como la humildad, prudencia y discreción se encontrarán en un nivel alto (siempre o en más del 80% de los casos) según la escala emedic -1. Resultados: Muestran que cuatro de los siete valores éticos calificaron alto, es decir se aplican siempre. En orden decreciente tuvieron el siguiente comportamiento: La prudencia, honestidad, fiabilidad, gentileza y discreción, diligencia, humildad, y veracidad en las notas clínicas. En cuanto a espíritu de servicio sólo dos de los 17 indicadores sobre el espíritu de servicio cayeron en calificación alta éstos son: El llamar al paciente por su nombre y evitar el trato frío e indiferente. Obtuvieron calificación media: La realización de procedimientos conforme a principios científicos y éticos, y el buen talante. Tres indicadores del espíritu de servicio deficientes son la flexibilidad ante las peticiones del paciente, olvido del paciente por exceso de trabajo, y la dificultad para ofrecer un "plus" en el servicio. Conclusiones: Un elemento muy destacable es el relacionado con el número de expertos que se reportan dentro del grupo estudiado. Más de la tercera parte de las entrevistadas se asumen como expertas clínicas. Los indicadores del espíritu de servicio que caracterizan al personal de enfermería entrevistado se expresan de manera diferenciada. Uno de los atributos mejor calificados es definitivamente el que se dirigen al paciente por su nombre evitando el trato frío o indiferente aunque lo deseable es que estos dos atributos vayan "siempre" acompañados de un buen talante al realizar los procedimientos.

Abstract: The phenomenon of study analysis is limited to the spirit of service and applies the values nurses in a clinical service. Objective: is to identify the level of spirit service and ethical values in the participating nurses. Methodology: Its was a descriptive study observational and cross in a institution of second level care with 340 nurses assigned, of which 100 answered a self-applied form (emedic ­ 1 with a Crombach of 0,915) of 26 items, distributed at the beginning of the shift and collected through the floor managers at the end of the journey. The information is analyzed in relative frequencies. The hypothesis were: Spirit of service level in the study will qualify as high and means according to the scale emedic-1; the ethical values inherent nursing care such as humility , prudence and discretion will be at level low in the scale emedic-1 Results: The ethical values of caring identified in descending order are: caution, honesty, reliability, gentleness, discretion, diligence, humility and truth in clinical notes. The relevant indicators of the spirit of service are: call the patient by name, to avoid the cold and indifferent treatment, performance of procedures under a scientific and ethical principles, and good humor. Three indicator of the poor spirit of service are flexibility to the demands of the patient, patient neglect by overwork, and difficulty to offer a "plus" service. Conclusions: one important element is the related with the number of experts, who where in in this investigation. More than the third part of the nurses are clinic experts, the indicators of the spiritual service, which characterized the nurses is expressed in different ways.One attribute is definitely the best qualified to address the patient by name to avoid indifferent treatment although it is desirable that these two attributes will "always" accompanied by a good mood to perform the procedures.

On the role of spectral resolution in velocity shear layer measurements by Doppler reflectometry.

The signal quality of a Doppler reflectometer depends strongly on its spectral resolution, which is influenced by the microwave beam properties and the radius of curvature of the cutoff layer in the plasma. If measured close to a strong perpendicular velocity shear layer, the spectrum of the backscattered signal is influenced by different velocities. This can give rise to two Doppler shifted peaks in the spectrum as observed in TJ-II H-mode plasmas. It is shown by two-dimensional full wave simulations that the two peaks are separable provided the spectral resolution of the system is sufficient. However, if the spectral resolution is poor, the two peaks blend into one and yield an intermediate and incorrect velocity.

Biphasic dosing regimen of meclizine for prevention of postoperative nausea and vomiting in a high-risk population.

The purpose of this study was to determine if giving 50 mg of meclizine the night before and on the day of surgery would effectively reduce postoperative nausea and vomiting (PONV) for the entire 24 hours after surgery in patients identified as being at high risk for PONV Subjects were randomly assigned to receive either 50 mg of oral meclizine (experimental group) or a placebo (control group) the night before and the day of surgery. All subjects were intravenously administered 4 mg of ondansetron before the conclusion of surgery. Seventy subjects (35 control; 35 experimental) were included in analysis. postoperaIn the placebo group we noted higher verbal numeric rating scale scores for nausea, a higher incidence oftive nausea and vomiting (PONV) continues to be a common complication after general anesthesia, with the incidence ranging from 17% to 87%.15 It has been reported that PONV increased antiemetic requirements, and lower overall anesthesia satisfaction scores at all time intervals measured, compared with the experimental group, but the differences were not statistically significant until analyzed by postoperative setting. No difference in sedation or side effects was noted between groups. Based on these results, we recommend that the administration of 50 mg of oral meclizine the night before and on the day of surgery be considered effective antiemetic prophylaxis in patients identified as having a high risk for PONV.

Doppler reflectometer system in the stellarator TJ-II.

A Doppler reflectometer system has recently been installed in the stellarator TJ-II. The system is optimized for the Q-band (33-50 GHz) and the high-curvature plasmas produced in TJ-II. The launch angle of the microwave beam can be controlled by a steerable mirror to obtain angles between +/-20 degrees enabling the measurement of perpendicular wave numbers in the range of 3-15 cm(-1). The available angular range allows for comparisons between positive and negative values and additionally for calibration of the system. Localization and k(perpendicular)-estimation is done via the three-dimensional ray/beam-tracing code TRUBA. First measured spectra and radial profiles of the perpendicular velocity of plasma density fluctuations are presented.

Atención a enfermos paliativos oncológicos en el domicilio: visión desde una unidad de emergencias médicas / No disponible

Objetivo: conocer las actitudes terapéuticas de un equipo de emergencias médicas cuando se enfrentan a un paciente oncológico en fase terminal en el domicilio. Métodos: estudio descriptivo y retrospectivo de los pacientes oncológicos paliativos atendidos en su domicilio por una unidad de emergencias médicas entre el 10/01/2005 y 30/06/2006. Variables: edad, sexo, diagnóstico principal, motivo activación, diagnóstico definitivo, entidad activadora, derivación hospital de referencia, tratamientos aplicados. Resultados: 18 pacientes fueron incluidos es este estudio con una media de edad de 65,4 años. 13/18 de los pacientes atendidos estaban diagnosticados de una neoplasia digestiva, broncopulmonar o del SNC. La disnea y las alteraciones en el nivel de conciencia fueron las causas más frecuentes por las que se movilizó al servicio de emergencia médicas que fue activado en 13 casos por el centro de salud. En 11 ocasiones se derivó el paciente al servicio de urgencias del hospital de referencia. Discusión: la mejoría en la comunicación efectiva debería incluir al paciente para poder consensuar, en la medida de lo posible, la intensidad y características de las actuaciones asistenciales que deberían ser llevadas a cabo en situaciones no esperadas de final de vida. La inclusión de registros específicos como el testamento vital y órdenes de no resucitación en la historia clínica ayudarían a facilitar la toma de decisiones en situaciones potencialmente graves e impactantes

Objective: to know the therapeutic attitudes of a medical emergency team when caring for palliative oncology patients at home. Methods: a descriptive, retrospective study in palliative oncology patients cared for in their homes by a medical emergency team from 10/01/2005 to 30/06/2006. Variables reviewed: age, gender, main diagnosis, reason for care, definitive diagnosis, referral to hospital, and treatment. Results: eighteen patients were included in the study with a mean age of 65.4 years. Thirteen of 18 patients had a diagnosis in either the digestive, lung or CNS area. Shortness of breath and decreased level of consciousness were the most important reasons for calling the emergency team. Local GPs were responsible for 13 of 18 conditions, and 11 patients were referred to the emergency room in the nearest acute hospital. Discussion: effective communication must include the patient whenever possible at the time of discussing the level of care to be carried out at the end of life. Do-not-resuscitate orders included in medical records would help medical teams in making the best decision at the most appropriate time when catastrophic events occur

Administración transdérmica de opioides mayores en Atención Primaria. Revisión de 1997 a 2004 / Transdermal major opioid delivery in Primary Care. A review from 1997 to 2004

Objetivos: valorar la prescripción de fármacos opioides mayores de administración transdérmica, en DDD (dosis diaria definida) por millón de habitantes/año y en %, entre 1997 y 2004, en la atención primaria de salud de la región sanitaria de Lleida. Material y métodos: estudio retrospectivo y descriptivo a partir de la base de datos del Servicio de Farmacia del Institut Català de Salut de la región sanitaria de Lleida. Utilizamos la clasificación ATC/DDD (Anatomical-Therapeutical-Chemical/dosis diaria definida) de los medicamentos, subgrupo NO2A, correspondiente a los fármacos opioides mayores y la fórmula DDD/106 hab/día para la cuantificación de los distintos opioides mayores. Resultados: la aparición de los opioides mayores de administración transdérmica en 1998 supuso un total de 34,9 DDD (14,04%), con un incremento progresivo hasta las 3.984 DDD prescritas en 2004 (97,84%) del total. Conclusiones: la presentación transdérmica de los opioides mayores ha dado como resultado más interesante el cambio en la tendencia en la prescripción de fármacos opioides en la atención primaria de salud en la región sanitaria de Lleida (AU)

Objectives: to evaluate the prescription of transdermal major opioids in DDDs (defined daily doses) per million inhabitants/year and %, between1997 and 2004 in the sanitary region of Lleida. Material and methods: a retrospective and descriptive study. Data were obtained from the pharmacy department of Catalan Health Institut eat the sanitary region of Lleida. We used the ATC/DDD drug classification, subgroup NO2A, corresponding to strong opioids, and the formula defined daily dose per 106 inhabitants and day to quantify the strong opioids prescribed. Results: since transdermal strong opiods became available for prescription in the primary care setting, 34.9 DDDs (14.04% of total) were prescribed in 1998. In 2004 3984 DDDs (97.84% of total) were prescribed in primary care. Conclusions: since transdermal strong opioids became available for prescription in 1998 there has been an interesting change in their pattern of prescription in the primary care setting of Lleida sanitary region (AU)

La saliva como método diagnóstico de los cambios en la concentración de inmunoglobulinas / Saliva as a diagnosis method of the concentration of immunoglobulins

La saliva es un líquido claro, algo viscoso, alcalino, que contiene un 95% de agua, un 3% de sustancias orgánicas y un 2% de sales minerales (grandes cantidades de iones de potasio y bicarbonato, y menos de iones cloro y sodio). La salivación está regulada completamente por el sistema nervioso. Las Inmunoglobulinas son proteínas anticuerpo altamente específicas que son producidas en respuesta a antígenos específicos. Los anticuerpos o inmunoglobulinas son producidos por los Linfocitos B en su forma unida a la membrana. Este anticuerpo unido a la membrana constituye el receptor de antígenos de la célula B. Los Linfocitos B secretan anticuerpos sólo tras su diferenciación, inducida por la interacción del antígeno con el anticuerpo de membrana de este tipo celular. La IgA es la inmunoglobulina predominante en la saliva y secreciones intestinales en forma de IgA secretoria, la mayoría se produce como resultado de una síntesis y no del torrente circulatorio. La IgG es producida y secretada por las células plasmáticas del bazo, los ganglios linfáticos y la medula ósea. Es la inmunoglobulina de mayor concentración en la sangre, por lo que desempeña la función más importante en los mecanismos de defensa mediados por anticuerpos.

The saliva is a sure liquid something viscous, alkaline, that contains a 95% of water, a 3% of organic substances and a 2% of mineral salts (great amounts of ions of potassium and bicarbonate, and less of ions chlorine and sodium). The salivation this regulated completely by the nervous system. The Immunoglobulin is highly specific proteins antibody that are produced in answer to specific antigens. The antibodies or immunoglobulin are produced by lymphocytes B in their form together with the membrone. This antibody together with the membrane constitutes the receiver of antigens of cell B. lymphocytes B secrete antibodies only after its differentiation, induced by the interaction of the antigen with the membrane antibody of this cellular type. The IgA is the predominant immunoglobulin in the saliva and intestinal secretions in form of IgA secretory, the majority takes place like result of a synthesis and not of the circulatory torrent. The IgG is produced by the plasmatic cells of bazo, the lymphatic ganglia and the bony marrow. It is the immunoglobulin of greater concentration in the blood, reason why defense by antibodies demists the most important function in half-full mechanisms.

In search of the elusive zonal flow using cross-bicoherence analysis

We show that the modulational instability growth rate of zonal flows is determined directly from the quasilinear wave kinetic equation. We also demonstrate the relation between zonal-flow growth and the cross bispectrum of the high-frequency drift-wave-driven Reynolds stress and the low-frequency plasma potential by explicit calculation. Experimental measurements of the spatiotemporal evolution of the spectrum integrated bicoherence at the L-->H transition near the edge shear layer indicate a modification in the nonlinear phase coupling, which might be linked to the generation of sheared ExB flows.

[Simultaneous coronary and carotid surgeries]. / Cirugía coronaria y carotídea simultánea.

Two patients with severe coronary artery disease and significant stenosis of the left internal carotid artery were operated upon. A combined or simultaneous operation was performed in both, carotid endarterectomy plus coronary artery bypass surgery was performed. The patients are symptoms-free after the operation and with evidence of satisfactory reconstruction in the carotid and coronary arteries. A review of the topic simultaneous revascularization of the carotids and coronary arteries in presented.

Petit mal and grand mal seizures produced by toluene or benzene intoxication in the cat.

Motor incoordination, euphoria and hallucinations are symptoms reported for humans voluntarily intoxicated by industrial solvents. An epileptic-like consciousness impairment has also been noted. The present paper describes a technique used for the experimental study of solvent intoxication in which toluene and benzene can be applied directly into the trachea of freely moving cats with chronically implanted electrodes. This technique permits the control of solvent dose and time of exposure. Results showed a 3 Hz spike-wave activity in the gyrus cinguli recording with both toluene or benzene intoxication. Furthermore, benzene inhalation produced generalized tonic-clonic seizures. These effects were dose-related. However, a sensitization period was essential for the development of such alterations, and effects showed a tendency to shortening through chronic exposures. These alterations were correlated with behavioral disturbances such as nodding, twitching and apparent hallucinations. Results are discussed regarding the sensitization period, the optimal peak of effects, and the period of tolerance development relevant to an earlier found amygdalar activation that could be correlated with other methods inducing experimental seizures, such as repetitive stimulation of the brain (kindling).